Nudge strategies for behavior-based prevention and control of neglected tropical diseases: A scoping review and ethical assessment.

<h4>Background</h4>Nudging, a strategy that uses subtle stimuli to direct people's behavior, has recently been included as an effective and low-cost behavior change strategy in low- and middle- income countries (LMIC), targeting behavior-based prevention and control of neglected tro...

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Main Authors: Fiona Vande Velde, Hans J Overgaard, Sheri Bastien
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-11-01
Series:PLoS Neglected Tropical Diseases
Online Access:https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0009239&type=printable
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author Fiona Vande Velde
Hans J Overgaard
Sheri Bastien
author_facet Fiona Vande Velde
Hans J Overgaard
Sheri Bastien
author_sort Fiona Vande Velde
collection DOAJ
description <h4>Background</h4>Nudging, a strategy that uses subtle stimuli to direct people's behavior, has recently been included as an effective and low-cost behavior change strategy in low- and middle- income countries (LMIC), targeting behavior-based prevention and control of neglected tropical diseases (NTDs). The present scoping review aims to provide a timely overview of how nudge interventions have been applied within this field. In addition, the review proposes a framework for the ethical consideration of nudges for NTD prevention and control, or more broadly global health promotion.<h4>Methods</h4>A comprehensive search was performed in several databases: MEDLINE, PsycINFO, and Embase (Ovid), Web of Science Core Collection, CINAHL, ERIC and Econ.Lit (EBSCO), as well as registered trials and reviews in CENTRAL and PROSPERO to identify ongoing or unpublished studies. Additionally, studies were included through a handpicked search on websites of governmental nudge units and global health or development organizations.<h4>Results</h4>This scoping review identified 33 relevant studies, with only two studies targeting NTDs in particular, resulting in a total of 67 nudge strategies. Most nudges targeted handwashing behavior and were focused on general health practices rather than targeting a specific disease. The most common nudge strategies were those targeting decision assistance, such as facilitating commitment and reminder actions. The majority of nudges were of moderate to high ethical standards, with the highest standards being those that had the most immediate and significant health benefits, and those implemented by agents in a trust relationship with the target audience.<h4>Conclusion</h4>Three key recommendations should inform research investigating nudge strategies in global health promotion in general. Firstly, future efforts should investigate the different opportunities that nudges present for targeting NTDs in particular, rather than relying solely on integrated health promotion approaches. Secondly, to apply robust study designs including rigorous process and impact evaluation which allow for a better understanding of 'what works' and 'how it works'. Finally, to consider the ethical implications of implementing nudge strategies, specifically in LMIC.
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spelling doaj-art-b9efd312b63044eaac509566b12d7aa82025-02-05T05:33:33ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352021-11-011511e000923910.1371/journal.pntd.0009239Nudge strategies for behavior-based prevention and control of neglected tropical diseases: A scoping review and ethical assessment.Fiona Vande VeldeHans J OvergaardSheri Bastien<h4>Background</h4>Nudging, a strategy that uses subtle stimuli to direct people's behavior, has recently been included as an effective and low-cost behavior change strategy in low- and middle- income countries (LMIC), targeting behavior-based prevention and control of neglected tropical diseases (NTDs). The present scoping review aims to provide a timely overview of how nudge interventions have been applied within this field. In addition, the review proposes a framework for the ethical consideration of nudges for NTD prevention and control, or more broadly global health promotion.<h4>Methods</h4>A comprehensive search was performed in several databases: MEDLINE, PsycINFO, and Embase (Ovid), Web of Science Core Collection, CINAHL, ERIC and Econ.Lit (EBSCO), as well as registered trials and reviews in CENTRAL and PROSPERO to identify ongoing or unpublished studies. Additionally, studies were included through a handpicked search on websites of governmental nudge units and global health or development organizations.<h4>Results</h4>This scoping review identified 33 relevant studies, with only two studies targeting NTDs in particular, resulting in a total of 67 nudge strategies. Most nudges targeted handwashing behavior and were focused on general health practices rather than targeting a specific disease. The most common nudge strategies were those targeting decision assistance, such as facilitating commitment and reminder actions. The majority of nudges were of moderate to high ethical standards, with the highest standards being those that had the most immediate and significant health benefits, and those implemented by agents in a trust relationship with the target audience.<h4>Conclusion</h4>Three key recommendations should inform research investigating nudge strategies in global health promotion in general. Firstly, future efforts should investigate the different opportunities that nudges present for targeting NTDs in particular, rather than relying solely on integrated health promotion approaches. Secondly, to apply robust study designs including rigorous process and impact evaluation which allow for a better understanding of 'what works' and 'how it works'. Finally, to consider the ethical implications of implementing nudge strategies, specifically in LMIC.https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0009239&type=printable
spellingShingle Fiona Vande Velde
Hans J Overgaard
Sheri Bastien
Nudge strategies for behavior-based prevention and control of neglected tropical diseases: A scoping review and ethical assessment.
PLoS Neglected Tropical Diseases
title Nudge strategies for behavior-based prevention and control of neglected tropical diseases: A scoping review and ethical assessment.
title_full Nudge strategies for behavior-based prevention and control of neglected tropical diseases: A scoping review and ethical assessment.
title_fullStr Nudge strategies for behavior-based prevention and control of neglected tropical diseases: A scoping review and ethical assessment.
title_full_unstemmed Nudge strategies for behavior-based prevention and control of neglected tropical diseases: A scoping review and ethical assessment.
title_short Nudge strategies for behavior-based prevention and control of neglected tropical diseases: A scoping review and ethical assessment.
title_sort nudge strategies for behavior based prevention and control of neglected tropical diseases a scoping review and ethical assessment
url https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0009239&type=printable
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